The Promise of Epigenetics. Has It Delivered New Insights?

Enrichment of GWAS signals within cell-specific enhancers defines cellular subsets most associated to IBD and highlights the critical role of epigenetics in IBD. We review the central role of the interleukin 23 (IL-23) pathway in cellular plasticity, mechanisms which are significantly mediated by epigenetic regulation of master transcription factors of various CD4+ T-cell subsets. Present studies need to be complemented by a deeper understanding of intestine-specific gene expression and epigenetics, especially in mononuclear phagocytes, given their enormous plasticity, and tissue-dependent function. A deeper understanding and application of epigenetics may impact and guide early treatment and ultimately, disease prevention in IBD.